Permit ELECTRICAL PERMIT
C I1Y OF TIGARD DATE 07 /24/96
°' ' COMMUNITY DEVELOPMENT DEPARTMENT
13125 SW Hall Blvd. Tigard, Oregon 97223.8199 (503) 639 -4171 PARCEL: 1 S 136 DB -02601
SITE ADDRESS...: 11606 SW PACIFIC HWY
SUBDIVISION ZONING:C —G
•
BLOCK • LOT
Project Description: Installing one feeder to 200amps.
- -- RESIDENTIAL UNIT - - -- -- -TEMP SRVC /FEEDERS - - -- MISCELLANEOUS
1000 SF OR LESS 0 0 - 200 amp • 0 PUMP /IRRIGATION • 0
EACH ADD'L 500SF...: 0 201 — 400 amp • 0 SIGN /OUT LINE LTG..: 0
LIMITED ENERGY 0 401 — 600 amp • 0 SIGNAL /PANEL • 0
MANF. HM/ SVC/FDR..: 0 601 +amps -1000 volts.: 0 MINOR LABEL (10)...: 0
- - -- SERVICE /FEEDER - - -- - - -- BRANCH CIRCUITS -- -ADD'L INSPECTIONS-- -
0 — 2 00 amp ° 1 W /SERVICE OR FEEDER: 0 PER INSPECTION • 0
201 — 400 amp : 0 1st W/0 SRVC OR FDR.: 0 PER HOUR ° 0
401 — 600 amp 0 EA ADD'L BRNCH CIRC: 0 IN PLANT ° 0
601 — 1000 amp ° 0 PLAN REVIEW SECTION
1000+ amp /volt • 0 > =4 RES UNITS ) 600 VOLT NOMINAL °.:
Reconnect only : 0 SVC /FDR >= 225 AMPS..: CLASS AREA /SPEC OCC.:
Owner: FEES
APPLIANCE CONNECTION type amount by date recpt
11606 SW PACIFIC HWY PRMT $ 60.00 CJS 07/23/96 96- 281992
5PCT $ 3.00 CJS 07/23/96 96- 281992
TIGARD OR 9723
Phone #:
Contractor:
PAGEL ELECTRIC $ 63.00 TOTAL
1927 21ST AVE
REQUIRED INSPECTIONS
FOREST GROVE OR 97116 Wall Cover Elect'1 Final
Phone #: 503 - 357 -4013 Elect'1 Service
Reg #°.: 107365
This permit is issued subject to the regulations contained in the
Tigard Municipal Code, State of Ore. Specialty Codes and all other Permittee Signature
applicable laws. All work will be done in accordance with
approved plans. This permit will expire if work is not started !1--
within 188 days of issuance, or if work is suspended for sore 1 'k G c'1 .\ on /cj T
than 188 days. Issued By
OWNER INSTALLATION ONLY - --
The installation is being made on property I own which is not intended for
sale, lease, or rent.
OWNER'S SIGNATURE: DATE:
CONTRACTOR INSTALLATION ONLY
•
SIGNATURE OF SUPR. ELEC' N : VYIC /p,1 DATE: „ F B/�
LICENSE NO:
Call for inspection — 639 -4175
Community Development ELECTRICAL PERMIT APPLICATION
13125 SW Hall Blvd.
Tigard, OR 97223 Permit # FLC96'Oh178
, � fl l�r I , Date Issued /ay.5
� � i� Phone (50 639 -4171
� ' ' ` FAX (503) 684 -7297
CITY OF TIGARD TDD No. (503) 684 -2772
Inspection (503) 639 -4175
1. Job Address: 4. Complete Fee Schedule Below:
Name of Development , _ Number of Inspections per permit allowed
Address //c , - £(o 610 � / G i4.tiy Service included: Items Cost(ea) Sum
City /State /Zip r ` 4,2 (1 , 6/2 9 7Z Z / 4a. Residential - per unit
r� ////���_ 1 000 Sq. ft. or less $110.00 4
Name (or name of business) �,� -A-W• Each additional 500 sq. ft. or
49p//97UCP.- portion thereof $25.00
Commercial RI Residential 111 Limited Energy $25.00 1
Each Manufd Home or Modular
Dwelling Service or Feeder $68.00 2
2a. Contractor installation only:
4b. Services o eede
/
Electrical Contractor - PACT ...II eC2'72t-C� Installation, alteration, or re ocation )
200 amps or less / $60.00 66 2
Address /927- ti *.% /Qoe 201 amps to 400 amps $80.00 2
Citya r r �� State 01 Zip /4 401 amps to 600 amps $120.00 2
601 amps to 1000 amps $180.00 2
Phone No. ` 7 - O/ a Over 1000 amps or volts $340.00 2
Job NO. /� 4 / Reconnect only
$50.00 2
contractor's license NO. G r -52 e 14(11'e'
4c. Temporary Services or Feeders
Contractor's Board Reg. • i :.*'- I Installation, alteration, or relocation
Signature of Supr. Elec'n 'i10,1'altIf 200 amps or less 2
-
License No. 224 Phone No , - '40/ 201 amps to 400 amps $50.00 2
401 amps to 600 amps $75.00
o• I 571 Over 600 amps to 1000 volts $100.00
2b. For owner installations: see "b" above.
4d. Branch Circuits
Print Owner's Name New, alteration or extension per pane
Address a) The fee for branch circuits with
purchase of service or feeder fee. 2
City State Zip Each branch circuit $5.00
Phone No. b) The fee for branch circuits withou
The installation is being made on property I own which is purchase of service or feeder fee. 2
not intended for sale, lease or rent. First branch circuit $35.00
Each additional branch circuit $5.00
Owner's Signature 4e. Miscellaneous
(Service or feeder not included) 2
3. Plan Review section (if required): Each pump or irrigation circle $40.00 2
Each sign or outline lighting $40.00
Signal circuit(s) or a limited energy 2
Please check appropriate item and enter fee in section 5B. panel, alteration or extension $40.00
4 or more residential units in one structure Minor Labels (10) $100.00
Service and feeder 225 amps or more
System over 600 volts nominal 4f. Each additional inspection over
Classified area or structure containing special occupancy the allowable in any of the above
as described in N.E.C. Chapter 5 Per inspection $35.00
p Per hour $55.00
In Plant $55.00
Submit 2 sets of plans with application where any of the above
apply. Not required for temporary construction services. 5. Fees:
5a. Enter total of above fees $
NOTICE 5% Surcharge (.05 X total fees)
PERMITS BECOME VOID IF WORK OR CONSTRUCTION Subtotal $
AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS, OR IF 5b. Enter 25% of line A for
CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR Plan Review if required (Sec.3) $
A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS Subtotal $
COMMENCED. v.'ordecomdev+eko- ❑ Trust Account #
$
prmapp
......*
Balance Due $
S7 4Sz Z
3/27/00 Activities for Case #: ELC96 -00478
5:38:16 PM
Assigned Hold Updated
Activity Description Date 1 Date 2 Date 3 To Done By Disp. Level By . Updated Notes
ELCC001 Application received 7/23/96 CJS RECD CJS 7/23/96
ELCC003 Permit created 7/23/96 CJS PEND CJS 7/23/96
ELCC500 (F)Issue permit 7/23/96 CJS PASS CJS 7/23/96
ELCC800 Case Finaled 7/19/96 MJR PASS MJR 7/31/96
Page 1 of 1
CITY OF TIGARD BUILDING INSPECTION NOTICE
Inspection Line: 639 -4175 Business Phone: 639 -4171
Footing Rain Drain Cover /Service FINAL:
Foundation Water Line Ceiling - Plumb.
Post/Beam Mech. Shear /Sheath Framing -Mech.
Plbg.Und/FIr/Slab Plbg. Top Out Insulation - Elect.
Post/Beam Struct. Mech. Rough -in Gyp. Bd. -Bldg.
San. Sewer Gas Line Appr /Sdwlk Reins.
Other: c 3) Z (/ / /7 `C•
7 G
Date: / / ! /(0 A.M. P.M. Entry: �]
Address: / f (Q tP D �./ _ L`T
Tenant te:, MST:
BUP:
Con /Own: 3 7 - ' j � / 3 MEC:
PLM:
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THE FOLLOWING CORRECTIONS ARE REQUIRED: ELR:
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Inspector: /� ( /r -e r _- / Date: _/ — 17
y APPROVED DISAPPROVED /CALL FOR REINSP ( 5 CO
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